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Epidemiology and outcome of an acute kidney injuries in the polytrauma victims admitted at the apex trauma center in Dubai

BACKGROUND: Polytrauma from road accidents is a common cause of hospital admissions and deaths, frequently leading to acute kidney injury (AKI) and impacting patient outcomes. METHODS: This retrospective, single-center study included polytrauma victims with an Injury Severity Score (ISS) >25 at a...

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Detalles Bibliográficos
Autores principales: Wankhade, Bhushan Sudhakar, Alrais, Zeyad Faoor, Alrais, Ghaya Zeyad, Hadi, Ammar Mohamed Abdel, Naidu, Gopala Arun Kumar, Abbas, Mohammed Shahid, Kheir, Ahmed Tarek Youssef Aboul, Hadad, Hasan, Sharma, Sundareswaran, Sait, Mohammad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Critical Care Medicine 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10265426/
https://www.ncbi.nlm.nih.gov/pubmed/37313668
http://dx.doi.org/10.4266/acc.2023.00388
Descripción
Sumario:BACKGROUND: Polytrauma from road accidents is a common cause of hospital admissions and deaths, frequently leading to acute kidney injury (AKI) and impacting patient outcomes. METHODS: This retrospective, single-center study included polytrauma victims with an Injury Severity Score (ISS) >25 at a tertiary healthcare center in Dubai. RESULTS: The incidence of AKI in polytrauma victims is 30.5%, associated with higher Carlson comorbidity index (P=0.021) and ISS (P=0.001). Logistic regression shows a significant relationship between ISS and AKI (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.150–1.233; P<0.05). The main causes of trauma-induced AKI are hemorrhagic shock (P=0.001), need for massive transfusion (P<0.001), rhabdomyolysis (P=0.001), and abdominal compartment syndrome (ACS; P<0.001). On multivariate logistic regression AKI can be predicated by higher ISS (OR, 1.08; 95% CI, 1.00–1.17; P=0.05) and low mixed venous oxygen saturation (OR, 1.13; 95% CI, 1.05–1.22; P<0.001). The development of AKI after polytrauma increases length of stay (LOS)-hospital (P=0.006), LOS-intensive care unit (ICU; P=0.003), need for mechanical ventilation (MV) (P<0.001), ventilator days (P=0.001), and mortality (P<0.001). CONCLUSIONS: After polytrauma, the occurrence of AKI leads to prolonged hospital and ICU stays, increased need for mechanical ventilation, more ventilator days, and a higher mortality rate. AKI could significantly impact their prognosis.